摘要
目的:探讨双能量CT小肠造影(DECTE)扫描技术评估克罗恩病(CD)活动度的可行性及价值。方法:回顾性分析经临床及病理证实的29例CD患者的临床表现、内镜及影像学资料,均行DECTE扫描。以临床应用的CD活动指数(CDAI)将患者分为活动组和缓解组,其中活动组(CDAI≥150)18例,共36个肠段;缓解组(CDAI<150)11例,共20个肠段。分析虚拟单能量CT值、能谱曲线斜率K及碘含量,通过受试者工作曲线(ROC)分析DECTE对CD活动度的诊断价值。结果:活动组肠壁的虚拟单能量CT值(除门脉期90、100 keV的虚拟单能量CT值外)、能谱曲线斜率K及碘含量均高于缓解组,差异均具有统计学意义(P均<0.05),且对活动期诊断价值高于缓解期(AUC均>0.5)。虚拟单能量CT值在动脉期60 keV时AUC最大(0.924),诊断CD肠段处于活动期的特异度较高(95%),但敏感度稍差(75%)。能谱曲线斜率K在门脉期时AUC最大(0.731),诊断CD肠段处于活动期的特异度较高(85%),但敏感度较低(58.3%)。碘含量在动脉期AUC最大(0.885),诊断CD肠段处于活动期的特异度高(100%),而敏感度稍差(61.1%)。结论:DECTE扫描的虚拟单能量CT值、能谱曲线斜率K及碘含量在评估CD活动期方面具有很好的诊断价值和较好的敏感度和特异度,可为临床精确诊断CD活动度提供参考。
Objective To investigate the feasibility and value of dual energy CT enterography(DECTE)in evaluating the activity of Crohn′s disease(CD).Methods The clinical manifestations,endoscopy and imaging data of 29 patients with CD confirmed by clinic and pathology were analyzed retrospectively.All the patients underwent DECTE scan.The clinical CD activity index(CDAI)was used as the disease activity grouping standard,and 29 cases were divided into 18 cases in active group(CDAI≥150)with a total of 36 intestinal segments,and 11 cases in remission group(CDAI<150)with a total of 20 intestinal segments.The differences in virtual single energy CT value,energy spectrum curve slope and iodine content were analyzed statistically.The diagnostic value of DECTE was evaluated by using receiver operating characteristic(ROC)analysis.Results The virtual single energy CT value(except the virtual single energy CT value of 90 and 100 keV in portal phase),curve slope and iodine content in the active group were higher than those in the remission group,and the differences were all statistically significant(all P<0.05).The diagnostic value in the active phase was higher than that in the remission phase(AUC>0.5).The AUC of virtual single energy CT was the largest at 60 keV in arterial phase(0.924),and the specificity of diagnosing CD intestinal segment in active phase was high(95%),but the sensitivity was slightly poor(75%).The AUC of the curve slope was the largest in the portal phase(0.731),and the specificity of diagnosing CD intestinal segment in the active phase was high(85%),but the sensitivity was low(58.3%).The AUC of iodine content was the highest in arterial phase(0.885),and the specificity of diagnosing CD intestinal segment in active phase was high(100%),but the sensitivity was slightly poor(61.1%).Conclusion The virtual single energy CT value,energy spectrum curve slope and iodine content have good diagnostic value,good sensitivity and specificity in the evaluation of CD activity,which can provide reference for clinical accurate diagnosis of CD activity.
作者
朱育婷
陈梦诗
罗敏
Zhu Yuting;Chen Mengshi;Luo Min(Department of Radiology,Fujian Provincial Hospital,Provincial Clinical College of Fujian Medical University,Fuzhou 350001,China;Department of Gastroenterology,Fujian Provincial Hospital,Fuzhou 350001,China;Zhangzhou Hospital,Zhangzhou 363000,Fujian Province,China)
出处
《中华炎性肠病杂志(中英文)》
2021年第4期321-326,共6页
Chinese Journal of Inflammatory Bowel Diseases
基金
2019年福建医科大学启航基金一般项目(2019QH1179)。
关键词
克罗恩病
计算机断层扫描
双能量CT
虚拟单能量图像
能谱曲线斜率
碘含量
Crohn′s disease
Computed tomographyr
Dual energy CT
Virtual single energy image
slope of energy spectrum curve
Iodine content